协和医学杂志

2019, v.10(05) 499-504

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肾脏叶间动脉阻力指数对Ⅰ型心肾综合征的诊断价值
Diagnostic Value of Resistive Index of the Renal Interlobar Artery in Type 1 Cardiorenal Syndrome

林霖;郭凯;杨萌;王冠男;
LIN Lin;GUO Kai;YANG Meng;WANG Guan-nan;Department of Ultrasound,Civil Aviation General Hospital;Emergency Department,PLA Army General Hospital;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Heart Center of Beijing Chest Hospital,Capital Medical University;

摘要(Abstract):

目的探讨彩色多普勒超声测量肾脏叶间动脉阻力指数(resistance index,RI)对Ⅰ型心肾综合征(cardiorenal syndrome,CRS)的诊断价值。方法选取2017年6月1日至2018年3月1日收住民航总医院急诊综合病房并诊断为Ⅰ型CRS的20例患者作为试验组(CRS组),选取同期诊断为单纯急性心力衰竭的患者20例作为对照组,分析两组患者的临床特征、实验室检查及用药情况,并根据受试者工作特征(receiver operating characteristic,ROC)曲线评价肾动脉RI对Ⅰ型CRS的诊断价值。结果两组患者年龄、左心室射血分数、心功能分级、心率及脉压差差异无统计学意义(P均>0. 05),CRS组患者的氨基末端脑钠尿肽、肌酐水平、呋塞米剂量以及肾动脉RI均高于对照组,而肾小球滤过率低于对照组,差异具有统计学意义(P均<0. 05)。ROC曲线下面积为0. 78,取最佳截点值0. 70时预测Ⅰ型CRS的敏感度为80%,特异度为80%。结论作为一种新的手段,肾动脉RI可与传统方法相互补充,对诊断Ⅰ型心肾综合征患者具有潜在应用价值。
Objective This study aimed to discuss the diagnostic value of the resistance index( RI) of the renal interlobar artery measured by color Doppler ultrasound in patients with type 1 cardiorenal syndrome( CRS). Methods Twenty patients with type 1 CRS diagnosed in emergency wards were defined as group CRS; 20 patients diagnosed as heart failure in the same period were defined as the control group. Clinical features,laboratory examination and medication of the two groups were analyzed. The RI of the two groups of patients was measured. The diagnostic value of RI in type 1 CRS was evaluated according to the receiver operating characteristic( ROC) curve. Results There was no significant difference in age,left ventricular ejection fraction( LVEF), heart rate, pulse arterial pressure,and cardiac function classification between the two groups( all P>0. 05). The level of N-terminal pro-brain natriuretic peptide,creatitine,and RI of CRS group were higher than those in the control group; the glomerular filtration rate in group CRS was lower than that in the control group,and the difference was statistically significant( all P < 0. 05). The area under the ROC curve was 0. 78 and the best cut-off point was 0. 70. The sensitivity was 80% and the specificity was 80%.Conclusions As a new means,the RI of the renal interlobar artery can complement traditional methods and has a potential value in the diagnosis of type 1 CRS.

关键词(KeyWords): 肾动脉超声;肾叶间动脉阻力指数;心肾综合征;诊断
renal artery ultrasound;renal interlobar artery resistance index;cardiorenal syndrome;diagnosis

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基金项目(Foundation): 北京市科技新星计划交叉学科合作课题(xxjc201812);; 科技部科技合作专项基金(2015DFA30440)

作者(Author): 林霖;郭凯;杨萌;王冠男;
LIN Lin;GUO Kai;YANG Meng;WANG Guan-nan;Department of Ultrasound,Civil Aviation General Hospital;Emergency Department,PLA Army General Hospital;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Heart Center of Beijing Chest Hospital,Capital Medical University;

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